Effectiveness of non-drug therapies in hypertension

A review published online on August 25, 2011 in the Journal of Clinical Hypertension concludes that lifestyle interventions such as the Dietary Approaches to Stop Hypertension (DASH) diet, as well as nutritional supplements including coenzyme Q10 (CoQ10) and potassium, are viable alternatives to drugs prescribed to help lower blood pressure.

“The treatment of hypertension is no longer limited to the simple prescription of pharmaceuticals,” write Kevin J. Woolf, MD and John D. Bisognano, MD, PhD of the University of Rochester Medical Center in their introduction to the article. “For many patients, maximal medical therapy is insufficient to adequately treat refractory hypertension. In addition, some patients may prefer to explore therapies that do not involve drugs as an initial step.”

Drs Woolf and Bisognano discuss the value of the low-sodium DASH diet, which provides greater amounts of fruit, vegetables and fiber and less fat than the average Western diet. Adherence to the DASH diet has been shown to lower systolic blood pressure by an average of 11.4 mmHg in hypertensive patients. This reduction is increased with the addition of weight loss counseling and an exercise program. Limiting smoking and alcohol consumption may also help reduce high blood pressure.

Herbal supplements discussed included forskolin, mistletoe and hawthorn. The authors also described devices such as the implantable Rheos device, the Symplicity catheter, the RESPeRATE device and the Zona Plus dynamometer, all of which have resulted in a significant reduction in systolic pressure when used by hypertensive patients.

“Right now we’re seeing a cultural shift where an increasing number of people want to avoid standard pharmaceuticals,” noted Dr Bisognano, who is the director of Outpatient Cardiology at the University of Rochester Medical Center. “We’re also seeing a growing number of patients who require a large number of drugs to control their blood pressure and are looking for something else to help manage it.”

“Patients have different backgrounds and different approaches to living their lives,” added Dr Woolf. “This is where the art of medicine comes in; getting to know patients and what they will and will not embrace can help physicians identify different therapies that suit their patients’ habits and that will hopefully make a difference for them.”

The Journal of Clinical Hypertension review article can be read at the

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